SUMTER ORAL & MAXILLOFACIAL SURGERY PA (NPI# 1083677884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083677884 |
| Entity Type | Organization |
| Organization Name | SUMTER ORAL & MAXILLOFACIAL SURGERY PA |
| Other Organization Name | DENTAL IMPLANT CENTER OF SUMTER |
| Practice Address |
1210 Wilson Hall Rd Sumter SC 29150-1889 |
| Practice Telephone | 8039054404 |
| Practice Fax Number | 8039054406 |
| Mailing Telephone | 8039054404 |
| Mailing Fax Number | 8039054406 |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2011-01-14 |
| Authorized Official Name | DR. MICHAEL A MCGINNIS (OWNER) |
| Authorized Official Telephone | 8039054404 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 3273 | SC | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
474 | SC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS BLUE SHIELD | ZDK433 | 01 |
| SC | ZA9858 | 05 | |
| UNITED CONCORDIA | 872701 | 01 | |
| AL | BLUE CROSS BLUE SHIELD | 88003121 | 01 |
| Other Name | Type Code |
|---|---|
| Dental Implant Center of Sumter | Doing Business As Name - Organization |
| Street Address |
1210 WILSON HALL RD |
| City | SUMTER |
| State | SC |
| Zip Code | 29150-1889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780648576 | Michael A Mcginnis | Dentist | 1210 Wilson Hall Rd, Sumter, SC 29150-1889 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174152557 | Stacey Delene Mcconico | Adult Companion | 201 East Liberty Street, Sumter, SC 29150 | 2020-04-07 |
| 1780227942 | Add Light Home Care LLC | In Home Supportive Care | 698-s Bultman Dr, Suite C-8, Sumter, SC 29150 | 2019-10-21 |
| 1770044075 | Kimberly A Weeks | Technician, Other | 5 E Liberty Street, Sumter, SC 29150 | 2019-03-28 |
| 1689155103 | Chrishena E Craig | Social Worker | 801 N. Pike West, Sumter, SC 29150 | 2018-08-23 |
| 1093200735 | Michael B Coseo | Dietitian, Registered | 1278 N. Lafayette Drive, Sumter, SC 29150 | 2018-06-26 |
| 1790287258 | Keever Murdaugh | Physical Therapy Assistant | 1018 North Guignard Drive, Sumter, SC 29150 | 2018-03-01 |
| 1679094643 | James D Pearson | Emergency Medical Technician, Basic | 9b Willow Drive, Sumter, SC 29150 | 2017-06-29 |
| 1245771781 | Shanekia Littles | In Home Supportive Care | 251 Rast St Unit D-1, Sumter, SC 29150 | 2017-03-16 |
| 1326590415 | Believe In Faith Home Care | In Home Supportive Care | 410 W Liberty St Suite 102, Sumter, SC 29150 | 2016-10-25 |
| 1912368457 | Urology Clinic, Inc. | Urology | 1285 Wilson Hall Rd, Sumter, SC 29150 | 2016-03-11 |
| Find all providers in zip 29150 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821047739 | Richard S Marks | Dentist | 5 Professional Ct, Sumter, SC 29150-1927 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963508 | Clements Ferry Dentistry LLC | Dentist | 1951 Clements Ferry Rd Ste 201, Charleston, SC 29492-8325 | 2020-05-11 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1164990164 | Camden Oral Surgery & Implant Center | Dentist | 207 E. Dekalb St., Camden, SC 29020 | 2018-11-07 |
| 1417309956 | Marian Mitchell Oliver Corp. | Dentist | 939 Jc Calhoun Drive, Orangeburg, SC 29115 | 2016-07-08 |
| 1205290764 | Sloan Rehder | Dentist | 2051 Sam Rittenberg Blvd, Charleston, SC 29407-4683 | 2016-04-11 |
| 1689039869 | Faircloth and Bakeman Partnership | Dentist | 150 Crepe Myrtle Dr, Aiken, SC 29803-7543 | 2015-12-15 |
| 1679954705 | Coafs Lab | Dentist | 125 Wappoo Creek Dr Ste C1, Charleston, SC 29412-2161 | 2015-06-15 |
| 1952798357 | Now Or Never 2011, LLC | Dentist | 2270 Ashley Crossing Dr Ste 175, Charleston, SC 29414-5863 | 2015-04-23 |
| 1922499011 | Chapin Oral and Maxillofacial Surgery, LLC | Dentist | 112 St. Peter's Church Road, Chapin, SC 29036 | 2015-02-10 |
| 1437557121 | Sumter Oral & Maxillofacial Surgery | Dentist | 624 Front St, Georgetown, SC 29440-3624 | 2014-12-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.